Last December, Julie Geiss got up too fast, felt dizzy and went to the refrigerator for a bottle of water.
“I must have passed out for a few seconds, because next thing I knew, I was lying on the couch and my head was bleeding. I figured I fell and I must have hit my head on the refrigerator or countertop. The bleeding stopped pretty quickly and I felt fine, so I went on with my day.”
The busy mother of two middle-school daughters doesn’t have time to baby herself. In fact, looking back, she admits now that she wasn’t taking very good care of herself in many ways.
She was feeling fine through the holidays and did not see a reason to visit her doctor about this incident. Then in early February, she noticed she was feeling tired, her equilibrium seemed a little off, and her handwriting seemed a little shaky.
When she went to her regular physician, Dr. Melissa Voutsalath, for her scheduled thyroid check at the Monument Primary Care Clinic, she mentioned her symptoms.
“I thought my symptoms were peri-menopausal, maybe,” she said. But Voutsalath suspected something else was going on and ordered a CT scan the following Monday. Dr. Voutsalath wanted the scan done right away.
“But I said I was too busy,” Geiss said. “I couldn’t imagine it was anything serious.”
When she did go for a CT scan, however, “they found something and they sent me straight to the ER.”
That’s where she met Dr. John McVicker, a neurosurgeon and director of Neurosciences at at UCHealth Memorial Hospital. In meeting Dr. McVicker, Geiss benefited from a rich network of medical expertise offered at UCHealth through the Colorado Health Medical Group, which has a plethora of skilled primary care physicians who can easily access specialists along Colorado’s Front Range.
“Dr. McVicker came in, did a few more tests and decided I needed brain surgery,” Geiss recalled. “I had a blood clot in the brain, probably from the fall. He called it a subdural hematoma. He said that sometimes it takes a while for symptoms to show up.”
Geiss’s symptoms were indeed concerning.
Dr. McVicker diagnosed “bifrontal, acute on chronic, mixed subdural hematoma, left considerably worse than right.’’
“She was clumsy in her dominant right hand, weak in the right arm, and stiff through the right side of her body, symptoms similar to what one may have after a stroke,” he said.
Geiss was scheduled for surgery the next morning. “it’s kind of good it happened so fast, because I didn’t have time to think about it,” she admitted. “I would have wanted to go home and get my girls ready for school and so on.”
The CT scan confirmed there was quite a bit of pressure on the left frontal part of the brain, pushing the brain to the right from where it normally lies, McVicker said.
“Surgery did not need to be done immediately, but was indicated to be done urgently, so we scheduled her for the next morning,” he recalled.
The surgery went well, and Geiss was out of the hospital by that Thursday.
“The morning after surgery she told us she felt much better than before surgery and her weakness had resolved,” Dr. McVicker said. “She had not had any seizures and was recovering very well, but we usually place post-operative patients on a precautionary dose of anticonvulsants, and she went home after the operation on this medicine.”
“I felt fine,” she said. “I was surprised, and so was everyone else. My hair had not been shaved off. I just had a little incision.”
Best of all, when she signed her discharge papers, her signature was normal again. Geiss took the anti-seizure medication, but then her right hand started feeling numb a few days later. Her cheek also felt a little numb.
On March 1, “she developed transient facial tingling and difficulty with speech that we thought might be a seizure,” Dr. McVicker said.
“My colleague on call increased her anti -seizure medicine. When this proved to be insufficient, a second, new anti-seizure medicine was added by our neurologist,” he said.
“It works faster and has fewer side effects,” she said.
The hardest thing was not being able to drive, she said. With a job and two very active daughters, it was more than a minor inconvenience. Luckily, her sister was able to come and help out for two weeks.
“That helped a lot,” Geiss said.
Things continued to improve and finally she was cleared to drive.
“I could still drive with my hand, even though I had the tingling, because it didn’t impair my ability to function,” she said. “I felt good but I had all these little issues.”
She’s been on anti-seizure medication for six months and is hoping to be able to stop taking it.
“She has done well with a good recovery of her presenting problems, and a CT scan that shows her hematoma is essentially gone,” Dr. McVicker said.
“We hope her seizures are a result of temporary irritation of the brain from the blood and will resolve, so yes, we are very optimistic,” Dr. McVicker said. “She is a very nice lady, we have been delighted to help.”
Geiss credits the good care she received from everyone, starting with Dr. Voutsalath and including Dr. McVickers’ physician assistant, for her recovery.
Geiss said she has learned a lot from the experience.
“We think my initial dizziness was from not eating,” she said. “I am very thin and I can go a long time without eating. And I work out.”
She’s more conscientious about her nutrition now. She tries to eat three meals a day, plus a few snacks, and drinks Ensure to supplement missed meals.
“I learned I am not invincible and that sometimes you need help from other people. That was a hard lesson for me,” Geiss said.
She admitted she is “very cautious now. I don’t care if my kids are just riding their scooters to the mailbox they wear their helmets. They joke with me and say maybe I should wear one, too – even just around the house.”